Active NPI
Lilly Fong, AGNP-C
- Nurse Practitioner
- Loma Linda, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 95013904
- Practice address
- 11370 Anderson St
Loma Linda, CA 92354-3450 - Phone
- (909) 558-2840
- NPI assigned
- May 9, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 95013904 | CA | |
| Nurse Practitioner | 363L00000X | 95013904 | CA | Primary |
| Adult Health Nurse Practitioner | 363LA2200X | NP95013904 | CA |
Addresses
Primary practice location
11370 Anderson St
Loma Linda, CA 92354-3450
Mailing address
11370 Anderson St Ste 1100
Loma Linda, CA 92354-3450
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
11370 Anderson St
Loma Linda, CA 92354-3450
901 San Bernardino Rd
Suite 104And302
Upland, CA 91786-4912
Phone (909) 558-4000
File Number
Suite 54701
Los Angeles, CA 90074-4701
Hospital & facility affiliations
- Loma Linda University Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.87 of 100
- Quality
- 72.13
- Promoting interoperability
- 80
- Improvement activities
- 40
- Cost
- 77.36
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95013904 | CA | MD | Nurse Practitioner |
| NP95013904 | CA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Loma Linda University Children'S Hospital | Past | Accepting new patients | |
| Loma Linda University Medical Center | Past | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Past | Accepting new patients | |
| Physicians' Hospital of Murrieta, LLC | Past | Accepting new patients |
Locations
81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830
11360 Mountain View Ave
Ste B
Loma Linda, CA 92354
Phone (909) 558-2830
11370 Anderson St
#1100
Loma Linda, CA 92354
Phone (909) 558-2830
11370 Anderson St
Ste 1100
Loma Linda, CA 92354
Phone (909) 558-2830
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
11370 Anderson St
Loma Linda, CA 92354
Phone (909) 558-2481
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700
901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779
Interoperability endpoints
- lfong6908@direct.llu.edu
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- NPI 1205009917
-
- Cardiovascular Disease Physician
- Loma Linda, CA
- NPI 1265686109
-
- Family Medicine Physician
- Moreno Valley, CA
- NPI 1558788331
-
- Orthopaedic Surgery Physician
- Loma Linda, CA
- NPI 1275582918
-
- Children's Hospital
- Loma Linda, CA
- NPI 1366866345
-
- General Acute Care Hospital
- Loma Linda, CA
- NPI 1194731935
-
- General Acute Care Hospital
- Murrieta, CA
- NPI 1386945947
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Loma Linda, CA
- NPI 1194731935
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770076800000",
"number": "1851913115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11370 ANDERSON ST STE 1100",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11370 ANDERSON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543450",
"telephone_number": "909-558-2840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONG",
"first_name": "LILLY",
"name_prefix": "Mrs.",
"credential": "AGNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-09",
"last_updated": "2026-02-03",
"certification_date": "2026-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "CA",
"license": "95013904",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "95013904",
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "CA",
"license": "NP95013904",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.